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Residents Page: Imaging
May 1999

Imaging Quiz Case 2

Author Affiliations
 

R. NICKBRYANMDS. JAMESZINREICHMD

Arch Otolaryngol Head Neck Surg. 1999;125(5):593. doi:

The axial contrast-enhanced computed tomographic scan showed a lobulated, dumbbell-shaped, fluid density collection in the midline and right of midline in what appears to be the sublingual space (Figure 1). There was mild peripheral soft tissue enhancement. It was difficult to precisely localize this lesion with axial images alone. To better characterize the lesion, contrast-enhanced MRI was performed. An MRI is excellent for imaging lesions of the oral cavity because of the MRI's multiplanar imaging capability and improved soft tissue contrast.1 The MRI demonstrated the intralingual location of this lesion. The sagittal T1-weighted image shows a low-signal lesion with peripheral enhancement within the tongue (Figure 2). The lesion was high signal on the T2-weighted sequences (Figure 3, arrow) as demonstrated by the coronal image. These findings are consistent with the fluid collection and could represent necrosis-infected material or mucus.

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